Evaluating the implementation of a prisoner re-entry initiative for individuals with opioid use and mental health disorders: Application of the consolidated framework for implementation research in a cross-system initiative
Evaluating the implementation of a prisoner re-entry initiative for individuals with opioid use and mental health disorders: Application of the consolidated framework for implementation research in a cross-system initiative
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DOI：
10.1016/j.jsat.2019.06.012
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发表时间：
2020-01-01
影响因子：
3.9
通讯作者：
Pinals, Debra A.
中科院分区：
文献类型：
--
作者：
Hanna, Julie;Kubiak, Sheryl;Pinals, Debra A.
鉴于阿片类药物使用、刑事司法相互作用和心理健康问题的相互关联性质，目前的阿片类药物危机迫切需要在涉及司法的人群中进行治疗，包括药物辅助治疗。实施研究在改进护理系统和整合刑事司法机构内外的循证实践方面发挥着重要作用。目前的研究是对阿片类药物国家靶向反应（STR）资金支持的跨系统（矫正和社区）阿片类药物使用治疗倡议实施情况的形成性定性评估。本研究的目的是评估实施研究综合框架（CFIR）与跨系统倡议的契合度，并确定实施的主要障碍和促进因素。过程评价表明，临床模式的适应性和工作人员的灵活性是实施的关键。惩教设施和社区治疗项目之间的文化和程序差异需要经常和有组织的论坛进行跨系统交流。通过协作开发和对政策和程序的持续审查，解决了与招聘和注册、人员配置、MAT和数据收集相关的挑战。本研究发现，CFIR是一个有用的框架，用于理解实施的吸收和障碍。该框架在加强利用执行研究作为不断改进进程的手段方面特别有价值。CFIR是一个全面而灵活的框架，可以在未来的跨系统评估中采用。
Given the interrelated nature of opioid use, criminal justice interaction, and mental health issues, the current opioid crisis has created an urgent need for treatment, including medication assisted treatment, among justice-involved populations. Implementation research plays an important role in improving systems of care and integration of evidence-based practices within and outside of criminal justice institutions. The current study is a formative qualitative evaluation of the implementation of a cross-system (corrections and community-based) opioid use treatment initiative supported by Opioid State Targeted Response (STR) funding.The purpose of the study is to assess the fit of the Consolidated Framework for Implementation Research (CFIR) to a cross-system initiative, and to identify key barriers and facilitators to implementation. The process evaluation showed that adaptability of the clinical model and staff flexibility were critical to implementation. Cultural and procedural differences across correctional facilities and community-based treatment programs required frequent and structured forums for cross-system communication. Challenges related to recruitment and enrollment, staffing, MAT, and data collection were addressed through the collaborative development and continuous review of policies and procedures.This study found CFIR to be a useful framework for understanding implementation uptake and barriers. The framework was particularly valuable in reinforcing the use of implementation research as a means for continuous process improvement. CFIR is a comprehensive and flexible framework that may be adopted in future cross-system evaluations.